No one told me if I did something wrong! can you tell me.

[holdensjane]

I am a student nurse working as a nursing assistant. Today I was a sitter for a patient that in report I told was stable, he had episodes of seizure activity three days ago but has since been asymptomatic. He has been walking to and from the bathroom with the help of his wife. When I talked to the charge nurse she told me that he does not really need a sitter but since i was there, she'd use me. I then talked to the nurse and asked if it was appropriate to sit inside the room or directly outside at a counter that is attached to the room, with the door open. Sitters i guess are supposed to sit inside the room, but when there is family at the bedside, it is customary to sit outside as long as the door is open and the patient is visible. the nurse said it was fine to sit outside cause the wife was there and he's stable. So i decided to sit outside cause the wife was there and the patient was still sleeping. He decides to go to the bathroom and the wife helps him after they tell me they don't need help. So i decide to give the patient his privacy as much as I can and am watching just outside the patient room doorway threshold into the bathroom, on his way up from the toilet he takes a step and starts going down. The wife assists him with his fall (he never actually hit the floor) and I immediately rush in as he is falling cause i see it happen. Its seizure like activity plus weakness. I call for help and everyone rushes him and its a big deal cause its a fall and all. Am I at fault cause I wasn't in the room? No one actually said it was my fault, but just told me to sit in the room from now on. I feel like it was my fault in that he fell and I wasn't next to him when it first happened, it happened so fast, but I did get from report that he was stable, both from the previous assistant, the night charge nurse and the day shift nurse. I even asked her where would be an appropriate place to sit, plus there was family in the room and the patient wanted privacy. It really bothered me because I wish someone would have just told me if I had done something wrong because then I could at least know what i could have changed. anyway, the patient later fell again on the way back from the toilet, this time I assisted the fall and I felt so incompetent this time cause the old snooty aid gave me that look like I was the worst assistant ever. the patient was later transferred to ICU because of the incidents, where he could be monitored on EKG. They're thinking it was due to heart blocks and weren't actually seizures. well in the ICU they're not allowed out of bed, but he did seizure twice more and five more times during the central line insertion. Then a convo between two docs goes like this:

"they're not seizures! where are you getting this verbage?!"

"the nurses said they were seizures"

"don't listen to the nurses, they don't know what they're talking about"

"the sitter said it was seizures" he then walks over to the charge and covering nurses

Then i may be paranoid but i get stares from them repeatedly. Okay, maybe they weren't seizures, but that is what I was told in report from the nurses! and thats what they said in report to the ICU nurses. and even during the central line insertion when they were happening, the docs and nurses in the room were yelling "he's seizing again! he's seizing!". After the first episode in the ICU doc unfamiliar with the patient walked in to help and asked what happened and being that I was the only person in the room with two spanish only speaking family members, I told him the patient seized again. was it inappropriate for me to have said "seized"? I was so uncomfortable and felt stupid all day. All I wanted so badly was for someone to tell me what I did wrong. I didn't have a supervisor to talk to cause I was floating all day and i was split between two units the floor and the ICU so there was continuinty in the people I could talk with about the situation. Can you tell me what it is I did wrong and advice about how to avoid it?

[TazziRN, RN]

Body jerks during syncopal episodes can resemble seizure activity.

As for whether or not you should have been in the room, if the pt was stable and it's routine to sit just outside the room when visitors are present, PLUS you had the charge nurse's permission to do so, I thinkk you're fine.

And even if you had been right there, the fall would have happened.

[msdobson]

I am a student nurse working as a nursing assistant. Today I was a sitter for a patient that in report I told was stable, he had episodes of seizure activity three days ago but has since been asymptomatic. He has been walking to and from the bathroom with the help of his wife. When I talked to the charge nurse she told me that he does not really need a sitter but since i was there, she'd use me. I then talked to the nurse and asked if it was appropriate to sit inside the room or directly outside at a counter that is attached to the room, with the door open. Sitters i guess are supposed to sit inside the room, but when there is family at the bedside, it is customary to sit outside as long as the door is open and the patient is visible. the nurse said it was fine to sit outside cause the wife was there and he's stable. So i decided to sit outside cause the wife was there and the patient was still sleeping. He decides to go to the bathroom and the wife helps him after they tell me they don't need help. So i decide to give the patient his privacy as much as I can and am watching just outside the patient room doorway threshold into the bathroom, on his way up from the toilet he takes a step and starts going down. The wife assists him with his fall (he never actually hit the floor) and I immediately rush in as he is falling cause i see it happen. Its seizure like activity plus weakness. I call for help and everyone rushes him and its a big deal cause its a fall and all. Am I at fault cause I wasn't in the room? No one actually said it was my fault, but just told me to sit in the room from now on. I feel like it was my fault in that he fell and I wasn't next to him when it first happened, it happened so fast, but I did get from report that he was stable, both from the previous assistant, the night charge nurse and the day shift nurse. I even asked her where would be an appropriate place to sit, plus there was family in the room and the patient wanted privacy. It really bothered me because I wish someone would have just told me if I had done something wrong because then I could at least know what i could have changed. anyway, the patient later fell again on the way back from the toilet, this time I assisted the fall and I felt so incompetent this time cause the old snooty aid gave me that look like I was the worst assistant ever. the patient was later transferred to ICU because of the incidents, where he could be monitored on EKG. They're thinking it was due to heart blocks and weren't actually seizures. well in the ICU they're not allowed out of bed, but he did seizure twice more and five more times during the central line insertion. Then a convo between two docs goes like this:

"they're not seizures! where are you getting this verbage?!"

"the nurses said they were seizures"

"don't listen to the nurses, they don't know what they're talking about"

"the sitter said it was seizures" he then walks over to the charge and covering nurses

Then i may be paranoid but i get stares from them repeatedly. Okay, maybe they weren't seizures, but that is what I was told in report from the nurses! and thats what they said in report to the ICU nurses. and even during the central line insertion when they were happening, the docs and nurses in the room were yelling "he's seizing again! he's seizing!". After the first episode in the ICU doc unfamiliar with the patient walked in to help and asked what happened and being that I was the only person in the room with two spanish only speaking family members, I told him the patient seized again. was it inappropriate for me to have said "seized"? I was so uncomfortable and felt stupid all day. All I wanted so badly was for someone to tell me what I did wrong. I didn't have a supervisor to talk to cause I was floating all day and i was split between two units the floor and the ICU so there was continuinty in the people I could talk with about the situation. Can you tell me what it is I did wrong and advice about how to avoid it?

Whoa! Eye strain! Eye strain!

Split your paragraphs!:flowersfo Split your paragraphs!:flowersfo

(falls on the ground, wheezing...)

[canoehead, BSN, RN]

If you had been right beside him holding his arm he still would have gone down.

Call them whatever you want, seizures, attacks, falling out, he loses control, and they need to be investigated. If they haven't actually ruled out seizures then it's as good a name as any. If the docs have a problem with it they can put a name to it, and you can switch your wordage.

[purple_rose_3]

Why was this pt. not on bedrest? That is what completely baffles me!

[Psqrd]

I've worked in health care a long time and have seen patients fall with staff right there holding on to them, so don't beat yourself up over this. Your covered as per the CN telling you it was ok to sit outside the room, you did what your supervisor told you to do.

"paragraph break for mike"

When I get the dirty looks, I stare back and say in a louder than inside voice "What?!"

Buts thats me making friends wherever I go! LOL!

P2

[msdobson]

I've worked in health care a long time and have seen patients fall with staff right there holding on to them, so don't beat yourself up over this. Your covered as per the CN telling you it was ok to sit outside the room, you did what your supervisor told you to do.

"paragraph break for mike"

When I get the dirty looks, I stare back and say in a louder than inside voice "What?!"

Buts thats me making friends wherever I go! LOL!

P2

Bless you, my child

[maryloufu]

I know where you are coming from feeling terrible all day first because you were not in the room and then with the docs. If you had been in that room you would have been uncomfortable because they wanted their privacy.

I think there will come a time when you decide what you are going to do and do it because you know that you have to do things the way you think they should be done or you will have trouble sleeping at night.

The docs talking about 'who said it was seizures?' and all- that is going to happen they even do that to each other. I had a specialist talk crap about a family practitioner because the family doc called in several specialists to find out what was wrong with the patient. The specialist is of course 2nd only to God and knows exactly what is wrong. I for one like a doctor who will use his resources and get other people in on the case when he is stumped.

So take a bubble bath and repeat some self affirming phrase and get this out of your system.

[Psqrd]

Bless you, my child

I like you Mike!!

Sarcasm rules!

P2

[P_RN, ADN, RN]

now this is why we were told over and over to tuck the word "apparently" into every sentence. as for sitters where they sit should be in the room. it's "avoiding the appearance of wrongdoing" and it's all just a cover your behind game.

[locolorenzo22, BSN, RN]

Now are you working as a CNA or as a sitter? Regardless of which, if you are a sitter, then everyplace has their own policies about what you are allowed to do....and ambulating patients usually isn't on there....

I work with hip/knee patients/neuros...and let me tell you...I had been a brand new (like 4 hour) floor orientee to my very first nursing assistant job....and I walk into a room cause someones yelling help, help weakly....and it's a man who had stumbled out of his recliner.....WOAH!!!!...I didn't even know enough to pull the call light out of the wall...just calmly went down to the station, told the nurse right away, and grabbed a dynamap and 4 other people to get him back to bed....guess how I felt the rest of the shift?.....

Falls happen....fact of life...we can precaution the heck out of our patients but we do what we can AND what they let us....

[RNDreamer]

***shaking my head and laughing***

You are too much!

Whoa! Eye strain! Eye strain!

Split your paragraphs!:flowersfo Split your paragraphs!:flowersfo

(falls on the ground, wheezing...)